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目的:探讨益活清下法早期联用用丙氨酰-谷氨酰胺二肽治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的疗效。方法:依据纳入和排除标准,选取我院中西医结合科收治的SAP80例,按1?1随机分成早期组(40例)和晚期组(40例),早期组入院时便应用丙氨酰-谷氨酰胺二肽治疗;晚期组入院5d后加用丙氨酰-谷氨酰胺二肽治疗。结果:两组入院时Ranson评分、CT评分、APACHEⅡ评分无统计学差异(P>0.05),治疗15d后早期组A-PACHEⅡ评分(4.97±2.39分)明显低于晚期组(8.63±3.57分)(P<0.01);两组并发ARDS、肾功能衰竭、休克、肝功能不全、心功能衰竭、脑病及肠麻痹的发生率无统计学差异(P>0.05);早期组ARDS、肾功能衰竭、休克、肝功能不全、脑病及肠麻痹持续时间及住院病程短于晚期组(P<0.05);早期组感染率、手术中转率及病死率低于晚期组(P<0.05)。结论:益活清下法早期应用丙氨酰-谷氨酰胺二肽治疗SAP,可缩短并发症的持续时间及病程,降低病死率和手术中转率。
Objective: To investigate the curative effect of early treatment of severe acute pancreatitis (SAP) with alanyl-glutamine dipeptide in the early phase of Yixinqingxiaowan. Methods: According to inclusion and exclusion criteria, 80 cases of SAP in our hospital were selected and randomly divided into early group (40 cases) and late stage group (40 cases) according to 1? 1. The patients in the early group were treated with alanyl - Glutamine dipeptide treatment; advanced group 5d after admission plus alanyl - glutamine dipeptide treatment. Results: There was no significant difference in Ranson score, CT score and APACHEⅡ score between the two groups (P> 0.05). The A-PACHEⅡ score of the early group after 15 days of treatment (4.97 ± 2.39) was significantly lower than that of the late group (8.63 ± 3.57) (P <0.01). The incidence of ARDS, renal failure, shock, hepatic insufficiency, heart failure, encephalopathy and intestinal paralysis were not significantly different between the two groups (P> 0.05) Shock, hepatic insufficiency, duration of encephalopathy and intestinal paralysis and hospitalization duration were shorter than those in advanced stage (P <0.05). In early stage, the infection rate, operative transfer rate and mortality were lower than those in advanced stage (P <0.05). Conclusion: The treatment of SAP with alanyl-glutamine dipeptide in the early phase of Yixinqingxiaowan can shorten the duration and duration of complications and reduce the mortality and surgical transfer rate.